Optic Neuritis
- 1 October 2019
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in CONTINUUM: Lifelong Learning in Neurology
- Vol. 25 (5), 1236-1264
- https://doi.org/10.1212/con.0000000000000768
Abstract
This article discusses the clinical presentation, evaluation, and management of the patient with optic neuritis. Initial emphasis is placed on clinical history, examination, diagnostic testing, and medical decision making, while subsequent focus is placed on examining specific inflammatory optic neuropathies. Clinical clues, examination findings, neuroimaging, and laboratory testing that differentiate autoimmune, granulomatous, demyelinating, infectious, and paraneoplastic causes of optic neuritis are assessed, and current treatments are evaluated. Advances in technology and immunology have enhanced our understanding of the pathologies driving inflammatory optic nerve injury. Clinicians are now able to interrogate optic nerve structure and function during inflammatory injury, rapidly identify disease-relevant autoimmune targets, and deliver timely therapeutics to improve visual outcomes. Optic neuritis is a common clinical manifestation of central nervous system inflammation. Depending on the etiology, visual prognosis and the risk for recurrent injury may vary. Rapid and accurate diagnosis of optic neuritis may be critical for limiting vision loss, future neurologic disability, and organ damage. This article will aid neurologists in formulating a systematic approach to patients with optic neuritis.Keywords
This publication has 100 references indexed in Scilit:
- Incidence and Prevalence of Major Central Nervous System Involvement in Systemic Lupus Erythematosus: A 3-Year Prospective Study of 370 PatientsPLOS ONE, 2013
- Clinical spectrum of tuberculous optic neuropathyJournal of Ophthalmic Inflammation and Infection, 2012
- Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritisJournal of Neuroinflammation, 2012
- Neurosyphilis Presenting as Asymptomatic Optic PerineuritisCase Reports in Ophthalmological Medicine, 2012
- Cerebrospinal fluid findings in adults with acute Lyme neuroborreliosisZeitschrift für Neurologie, 2011
- Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosisBMC Neurology, 2010
- Optical coherence tomography helps differentiate neuromyelitis optica and MS optic neuropathiesNeurology, 2009
- Optical coherence tomography differs in neuromyelitis optica compared with multiple sclerosisNeurology, 2009
- Multiple Sclerosis Risk After Optic NeuritisArchives of Neurology, 2008
- Central Nervous System Tuberculosis: Pathogenesis and Clinical AspectsClinical Microbiology Reviews, 2008